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The importance of housekeeping



dr richard cook duotone 3x2

As I sit here writing, I have a glorious view out of my kitchen window. You may be imagining rolling fields and the glint of the sea in the distance. Unfortunately not.

All I can see is a soggy seven-man tent that I have just finished putting up in the garden to dry out after a family excursion to Wales. I wasn’t part of the family excursion, but my holiday arrangements and work/life balance are a discussion for another day.

If you have ever returned from a camping trip with a sopping tent you will know the score – you study the weather forecast furiously with the aim of getting the tent up for a few hours to dry out enough so that you can forget about it and tuck it away until next time (another year, in our case).

It’s a bit like managing appraisals, except that at least the tent provides some enjoyment.

Without the patients – the human connections – our job is nothing

You could call it housekeeping, if you like, which seamlessly brings me on to the topic of my own appraisal and ‘career aspirations’. I have written before about appraisal and my views remain unaltered. I have had quite a few discussions this year with colleagues, allied health professionals and family about the career of medicine, what it means and what I want from life.

Amazingly I have not included this in my appraisal folder or claimed any CPD points, largely because I couldn’t be bothered, but also because I can’t really see how it is the business of the ‘responsible officer’.

Housekeeping is important, though. I am no educationalist myself, but we have all heard of Neighbour. His Inner Consultation remains a must-read for any GP, and should in my view be essential reading for all medics. I believe his housekeeping checkpoint can apply not just to our next patient, but also to our next surgery, next week’s diary and so on. It is more important than ever to look after ourselves and colleagues, given the pressure we face each day.

So on to career aspirations and my proposed PDP. ‘My main aim is to spend more of my time this year concentrating on writing protocols, attending non-productive meetings, chasing up secondary care and browsing twitter,’ is what I wanted to write. But that would have left me with nothing to aim for next year, so I had a rethink.

Why do we do our job? Human connections – at least, that’s the reason for me. Having discussed and chewed this over, I keep coming back to it. Without the patients, and the connections, the job is nothing. Those GPs who shy away from this are missing the point, in my view, of why we are here.

Unfortunately, there is no recognition in the appraisal for housekeeping, maintaining sanity and keeping going through means outside the sphere of medicine – it is not a holistic process. My proposed PDP cannot include my wish to cycle over the highest road in Europe next month, or to travel to the Pantanal to photograph Jaguars. Yet these are the activities that will keep me working, and also more able to connect with patients.

I’m a fifty something potential statistic. NHS England needs to wake up before we hang ourselves out to dry like the tent.

Dr Richard Cook is a GP in west Sussex